氨氯地平和依那普利对老年纯收缩期高血压患者动态血压的影响

目的　比较氨氯地平和依那普利对老年纯收缩期高血压患者的 2 4h动态血压的影响。方法　将 6 0例轻中度纯收缩期高血压老年患者随机分为两组 ,每组 30例。分别选用氨氯地平片 5mg和依那普利片 10mg ,每日一次 ,共 4周。用药前后进行 2 4h动态血压监测。结果　两组药物治疗第 4周末 2 4h动态血压发现 ,2 4h平均收缩压、脉压、舒张压、平均动脉压均较服药前明显降低 ,统计学上有显著性差异。氨氯地平组治疗后总体收缩压和舒张压分别下降 17.0 3± 8.5 5mmHg和 4 .83± 4 .82mmHg ;平均动脉压下降了 8.86± 4 .76mmHg ,依那普利组治疗后总体收缩压和舒张压分别下降 14 .30± 7.2 6mmHg和 5 .97± 2 .87mmHg ,平均动脉压下降了 8.74± 3.0 7mmHg ,组间比较收缩压下降幅度无差异 (P =0 .187) ,脉压下降幅度有统计学意义 (P =0 .0 0 5 )。氨氯地平组脉压差下降幅度大于依那普利组 (16 .97± 14 .0 6mmHg比 8.33± 7.84mmHg ,P =0 .0 0 5 ) ,两药对舒张压的影响组间比较无统计学差异。两组有效率相似 (76 .7%比 73.3% ,P =0 .76 6 ) ,达标率的差异无统计学意义 (6 6 .7%比 5 6 .7% ,P =0 .4 2 6 )。氨氯地平组发生胫前水肿 2例 ,依那普利组咳嗽 5例。结论　氨氯地平与依那普利对老年纯收缩期高血压均有效 ,尤其

Comparison of the Effects of Amlodipine and Enalapril in 24 h Ambulatory Blood Pressure in Elderly Patients with Isolated Systolic Hypertension

Aim To evaluate the efficacy of amlodipin and enalapril on 24 h ambulatory blood pressure(ABPM) in elderly patients with mild to moderate isolated dystolie hypertension(ISH). Methods Sixty elderly patients whose average age was 64 years old with ISH were randomly divided into two groups and were treated with 5mg/d amlodipine,10mg/d enalapril respectively for 4weeks.The changes of ABPM were compared before and four weeks after treatment. Results (1)After 4 weeks treatment,there were significant differences in lowering systolic blood pressure(SBP), and pulse pressure(PP)in the two groups respectively. The total average systolic and diastolic blood pressure decreased by 17.03±8.55 mm Hg(p<0.001) and 4.83±4.82 mm Hg in the amlodipine group,by 14.30±7.26 mm Hg(p<0.001)and 4.97±2.87 in the enalapril group. 24 h mean blood pressure(MAP) decreased 8.86±4.76 mm Hg(p<0.001) in amlodipine group,decreased 8.74±3.07 mm Hg(p<0.001) in enalapril group.(2)PP was decreased by 16.97±14.06 mm Hg (p<0.001) in the amlodipine group,by 8.33±7.84 mm Hg(p<0.001) in the enalapril group.(3)Both drugs were similarly effective in 76.7% patients and 73.3% patient respectively (P=0.766),and goal blood pressure was achieved in 66.7% patients treated with amlodipin, 56.7% with enalapril (P=0.426).(4)The incidence of drug-related dependent side-effects were 6.67% in the amlodipine group,16.67% in the enalapril group. Conclusion (1)The data show that both amlodipin and enalapril can significantly decrease SBP, MAP and PP. There are no significant difference in lowering blood pressure between two groups.(2)Amlodipin 5mg,and enalapil 10mg once daily is effective and safe in patients with mild to moderate hypertension.